Document Detail

Contribution of indirect computed tomography venography to computed tomography angiography of the chest for the diagnosis of thromboembolic disease in two United States emergency departments.
MedLine Citation:
PMID:  12871397     Owner:  NLM     Status:  MEDLINE    
Recent reports suggest that physicians in non-ambulatory settings can use indirect CT venography (CTV) of the lower extremities immediately following spiral CT angiography (CTA) of the chest to identify patients with a negative CTA who have thromboembolic disease identified on CTV. We sought to determine the frequency of isolated deep venous thrombosis (DVT) discovered on CTV in emergency department (ED) patients with complaints suggestive of pulmonary embolism (PE) yet having a negative CTA. This study was conducted in a suburban and urban ED where patients with symptoms suspicious for PE were primarily evaluated with CTA and CTV. A total of 800 patients were studied, including 360 from the suburban ED and 440 from the urban ED. 88 (11%) patients were diagnosed with thromboembolic disease by CTA, or CTV, or both. Seventy-three patients had a CTA of the chest that was positive for PE, 42 (5.2%) of whom had evidence of both PE on CTA and DVT on CTV. Fifteen patients (2%, 95% CI = 1-3%) had a negative CTA and were subsequently found to have isolated DVT on CTV, all of whom received anticoagulation therapy. These data suggest that indirect CT venography of immediately following CT angiography of the chest significantly increased the frequency of diagnosed thromboembolic disease requiring anticoagulation in ED patients with suspected PE.
P B Richman; J Wood; D M Kasper; J M Collins; R W Petri; A G Field; D N Cowles; J A Kline
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of thrombosis and haemostasis : JTH     Volume:  1     ISSN:  1538-7933     ISO Abbreviation:  J. Thromb. Haemost.     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-07-21     Completed Date:  2003-11-04     Revised Date:  2006-11-07    
Medline Journal Info:
Nlm Unique ID:  101170508     Medline TA:  J Thromb Haemost     Country:  England    
Other Details:
Languages:  eng     Pagination:  652-7     Citation Subset:  IM    
Department of Emergency Medicine and Mayo Clinic Hospital, Scottsdale, Arizona, USA.
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MeSH Terms
Angiography / methods*
Emergency Medical Services / methods*
Middle Aged
Phlebography / methods*
Predictive Value of Tests
Pulmonary Embolism / radiography
Radiography, Thoracic / methods*,  standards
Retrospective Studies
Thromboembolism / radiography*
Tomography, X-Ray Computed / methods,  standards
United States

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